PUBMIC (Prophylactic Use of Biologic Mesh in Ileal Conduit)
Prevention of Parastomal Hernia Following Radical Cystectomy and Ileal Conduit Using Biologic Mesh: Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To estimate the rate of developing parastomal hernia detected either clinically or radiologically in patients with radical cystectomy and ileal conduit, with or without mesh.
SECONDARY OBJECTIVES:
I. To estimate the rate of developing symptomatic parastomal hernia requiring surgical intervention in patients with radical cystectomy and ileal conduit with or without mesh.
II. To estimate the time from cystectomy with an ileal conduit to diagnosis of clinical parastomal hernia development in patients with radical cystectomy and ileal conduit with or without mesh.
III. To estimate the time from cystectomy with an ileal conduit to diagnosis of radiological parastomal hernia development in patients with radical cystectomy and ileal conduit with or without mesh.
IV. To estimate the rate of stomal prolapse and time to its development in patients with radical cystectomy and ileal conduit with or without mesh.
V. To evaluate mesh-related complications in mesh group.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo placement of biologic mesh during radical cystectomy and placement of the ileal conduit.
ARM II: Patients undergo standard of care radical cystectomy and placement of the ileal conduit.
After completion of study, patients are followed up every 2-4 months for 2 years.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Los Angeles, California, United States, 90033
- USC / Norris Comprehensive Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Bladder cancer, undergoing radical cystectomy and ileal conduit diversion
- Ability to understand and the willingness to sign a written informed consent
- Follow-up either here at University of Southern California (USC) or centers that are available to transfer the requested clinical and radiological data
Exclusion Criteria:
- Previous scar or mesh at the level of ileal conduit
- Survival less than 12 months after surgery (either predicted survival before surgery or actual survival after surgery < 12 months)
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to cadaveric component, i.e. Flex HD
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm I (biologic mesh)
Patients undergo placement of biologic mesh during radical cystectomy and placement of the ileal conduit.
|
Undergo intraperitoneal prophylactic mesh placement
Other Names:
|
|
No Intervention: Arm II (no intervention)
Patients undergo standard of care radical cystectomy and placement of the ileal conduit.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of development of a clinical or radiologic parastomal hernia
Time Frame: Up to 2 years
|
Cumulative incidence curves (using death, local recurrence, other surgical procedures unrelated to the development of parastomal hernias as competing risks) and their associated estimates (at 2 years) and standard errors will be used.
To compare the two arms, the Wald test for the estimate at two years will be used, and the log-rank test for the timing of the events will be used.
All tests will be one-sided at the 0.05 level.
|
Up to 2 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of mesh-related complications in Mesh group (Arm I)
Time Frame: Up to 2 years
|
All patients randomized, who undergo a radical cystectomy with an ileal conduit, will be classified according to whether or not they received the mesh implant.
Observed toxicities and complications during and after surgery will be summarized by treatment received, severity, timing (time from surgery), and frequency.
|
Up to 2 years
|
|
Rate of development of symptomatic parastomal hernia requiring surgical intervention
Time Frame: Up to 2 years
|
Cumulative incidence curves (using death, local recurrence, other surgical procedures unrelated to the development of parastomal hernias as competing risks) and their associated estimates (at 2 years) and standard errors will be used.
To compare the two arms, the Wald test for the estimate at two years will be used, and the log-rank test for the timing of the events will be used.
All tests will be one-sided at the 0.05 level.
|
Up to 2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Hooman Djaladat, University of Southern California
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Pathological Conditions, Anatomical
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urologic Neoplasms
- Urinary Bladder Diseases
- Urinary Bladder Neoplasms
- Hernia
Other Study ID Numbers
Other Study ID Numbers
- 4B-14-2 (Other Identifier: USC / Norris Comprehensive Cancer Center)
- P30CA014089 (U.S. NIH Grant/Contract)
- NCI-2015-00278 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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